Gender differences in the prevalence, causes and treatment of high cardiovascular risk: findings from the FINRISK Survey

Background: Concerns have been raised that high cardiovascular (CVD) risk is not always recognized in women and treated effectively enough. We aimed to analyze, whether there are differences between men and women in the prevalence, underlying causes and treatment of high CVD risk. Design: A cross-sectional analysis of data from population-based health examination surveys was conducted. Methods Pooled data from the population-based National FINRISK Surveys from the years 1992, 1997, 2002 and 2007 were used. Subjects with any of the following were considered as having high-risk: history of a major CVD event, prevalent diabetes or 10-year risk of CVD >= 20% calculated according to the Framingham equation. Results: We identified 835 (46.0% women) high-risk subjects in the age group 25-54 years and 3587 (27.3% women) in the age group 55-74 years. In the younger age group men had more often prevalent CVD (29.3% vs 7.8%, p < 0.001) and were more likely to be smokers (46.3% vs 21.4%, p < 0.001), whereas women had more diabetes (94.0 % vs 60.5%, p < 0.001). Younger women were less likely to achieve the recommended total cholesterol level of <4.5 mmol/l (14.3 % vs 17.3 %, p = 0.03) and had a lower rate of hypolipidaemic therapy (9.6% vs 21.2%, p < 0.001) and acetylsalicylic acid therapy (8.3% vs 27.7%, p < 0.001). Conclusion: Among young individuals, high CVD risk was almost as common in women as in men. It appears that the high-risk situation is not always recognized and treated adequately in young women.